The activity of hemostatic and oxidative-reduction systems according to different classes of ulcer bleeding


  • І.I. Dutka
  • F.V. Grynchuk
Keywords: ulcer bleeding, redox reactions, hemostasis, recurrence prediction, treatment

Abstract

Haemostatic therapy of ulcer bleeding (UB) is based on activation of the coagulation system and depression of the fibrinolytic one. Though not so much attention is paid to the oxidation-reduction system. Aim of the study To elaborate the recommendations on optimization of hemostatic therapy. Were examined 25 patients with UB. 4 patients were evaluated by Forrest classification, type ІВ, 5 – type ІІА, 6 — type ІІВ, and 10 — type ІІІС. Patients with type ІВ had endoscopic haemostasis procedures. All patients got a standard haemostatic complex. Two patients who were evaluated by Forrest classification type ІІА had bleeding recurrence. The following data was determined in blood plasma: fibrinolytic and proteolytic activity, fibrinase, antithrombin ІІІ, prothrombin index, isolated double bonds, diene conjugates, cetodienes and conjugated trienes, oxidation of neutral and alkaline proteins, malonic aldehyde, renew glutathione, catalase. Patients who were evaluated by Forrest classification type ІІА had both a disorder of redox system and hemostasis system balance, caused by a violation of synthesis of its factors. This contributes to the occurrence of bleeding recurrence. The results of redox system together with the criteria for hemostasis condition can be used to predict the recurrence of ulcer bleeding. Medicinal measures need to be adjusted, and antioxidants together with hepatoprotectors to be prescribed. So, patients with UB recurrence have an excessive activation of lipoperoxidation, low level of basic proteins, decrease in functional capacity of antioxidant mechanisms and hemostasis system imbalance, caused by a violation of synthesis of its factors, it is essential to take into account while predicting UB recurrence, and in case of UB one should add to the medication management those means that inhibit the activity of lipid oxidation and contribute to the restoration of synthesis processes of hemostasis factors. The prospect of further development is the assessment of the effectiveness of an optimized treatment complex.

References

1. Matviichuk, B. O., Rachkevych, S. L., Tumak, I. M., Korol, Ya. A., Pater, Ya. Z., Kushniruk, O. I., Artiushenko, M. Ye., Kohut, L. M., Hula, H. V., Hasoshyn, V. A., Pohoretskyi, P. V., Bubniak, M. R. (2015). Prohnozuvannia retsydyvu vyrazkovykh krovotech pislia endoskopichnoho hemostazu [Prognostication of recurrence of ulcer bleeding after endoscopic hemostasis]. Acta medica Leopoliensia, 21(3), 53–58.

2. Monastyrskyi, V. A. (2007). Trombin-plazminova systema – odna z osnovnykh rehuliatornykh system orhanizmu [The thrombin-plasma system is one of the main regulatory systems of the body]. – Lviv: Liha-Pres.

3. Nykytyn, E. V., Verba, N. V., Vereshchahyna, A. Y. (2013) Perekysnoe okyslenye lypydov (POL), antyoksydantnaia systema (AOS) y hemostaz: u zdorovыkh liudei y pry hepatytakh [Peroxide oxidation of lipids (LPO), antioxidant system (AOS) and hemostasis: in healthy people and in hepatitis]. Hepatolohiia – Hepatology, 3, 5–20.

4. Trofimov, M. V., Kryshen, V. P., Muntian, S. O. (2016). Likuvalna taktyka pry shlunkovo-kyshkovii krovotechi vyrazkovoho genezu [Therapeutic tactic for gastrointestinal bleeding of ulcer genesis]. Klinichna khirurhiia – Clinical Surgery, 9, 11–13.

5. Adach, W. & Olas, В. (2017). The role of CORM-2 as a modulator of oxidative stress and hemostatic parameters of human plasma in vitro. PLoS One, 12 (9), e0184787. https://doi.org/10.1371/journal.pone.0184787.

6. Cheng, H. C., Wu, C. T., Chen, W. Y., Yang, E. H., Chen, P. J. & Sheu, B. S. (2016). Risk factors determining the need for second-look endoscopy for peptic ulcer bleeding after endoscopic hemostasis and proton pump inhibitor infusion. Endoscopy International Open, 4 (3), 255–262. doi: 10.1055/s-0041-111499.

7. Colman, R. W. (Еd.). (2001). Hemostasis and thrombosis: basic principles and clinical practice (4th ed.). Philadelphia: Lippincott Williams & Wilkins. SBN-13: 978-1608319060; ISBN-10: 9781608319060

8. Davies, M. J. (2016). Protein oxidation and peroxidation. Biochemical Journal, 473 (7), 805–825. doi: 10.1042/BJ20151227.

9. Espinosa-Diez, C., Miguel, V., Mennerich, D., Kietzmann, T., Sanchez-Perez, P., Cadenas, S. & Lamas, S. (2015). Antioxidant responses and cellular adjustments to oxidative stress. Redox Biology, 6, 183–197. doi: 10.1016/j.redox.2015.07.008.

10. Farrar, F. C. (2018). Management of Acute Gastrointestinal Bleed. Critical Care Nursing Clinics of North America, 30 (1), 55–66. doi: 10.1016/j.cnc.2017.10.005.

11. Forrest, J. A., Finlayson, N. D. & Shearman, D. J. (1974). Endoscopy in gastrointestinal bleeding. The Lancet, 2 (7877), 394–397. Retrieved from http://dx.doi.org/10.1016/S0140-6736(74)91770-X.

12. Laursen, S. B. (2014). Treatment and prognosis in peptic ulcer bleeding. Danish Medical Journal, 61 (2), 4797. https://www.ncbi.nlm.nih.gov/pubmed/24495895.

13. Longstaff, C. & Kolev, K. (2015). Basic mechanisms and regulation of fibrinolysis. Journal of Thrombosis and Haemostasis, 13 (1), 98–105. doi: 10.1111/jth.12935.

14. Scally, B., Emberson, J. R., Spata, Е., Reith, C., Davies, К., Halls, Н. & Baigent, С. (2018). Effects of gastroprotectant drugs for the prevention and treatment of peptic ulcer disease and its complications: a meta-analysis of randomised trials. The Lancet Gastroenterology & Hepatology, 3 (4), 231–241. DOI:https://doi.org/10.1016/S2468-1253(18)30037-2.
Published
2018-09-28
How to Cite
DutkaІ., & Grynchuk, F. (2018). The activity of hemostatic and oxidative-reduction systems according to different classes of ulcer bleeding. Reports of Vinnytsia National Medical University, 22(3), 460-463. https://doi.org/https://doi.org/10.31393/reports-vnmedical-2018-22(3)-12